Can I take Apixaban and Sertraline together?

Why this happens

Apixaban is an anticoagulant (blood thinner) that prevents clots. Sertraline is an SSRI antidepressant which, as a side effect, can reduce the ability of your platelets to stick together. When both medicines work to 'thin' the blood in different ways, the risk of bleeding rises.

What you should do

You can take these together if your doctor has prescribed both, but you must be extra vigilant. Watch for signs of unusual bleeding, such as blood in your urine, black tarry stools, coughing up blood, or heavy nosebleeds. Seek medical advice immediately if you have a fall or a head injury.

Important precautions

Increased bleeding risk

Taking these medicines together significantly increases your risk of serious internal bleeding. You must watch for signs like coughing up blood, vomit that looks like coffee grounds, or black, tarry stools.

Emergency surgery or injury

Because apixaban prevents blood clotting, you are at risk of life-threatening bleeding if you have a serious injury or need emergency surgery. You must carry an anticoagulant alert card at all times to inform medical staff.

Low blood sodium (Hyponatraemia)

This medicine can cause a dangerous drop in sodium levels, especially in the elderly. Seek medical help if you experience new confusion, muscle weakness, or seizures.

Food and drink warnings

Alcohol

It is best to avoid drinking alcohol while taking sertraline. Alcohol can increase the sedative effects of the medicine, making you feel more sleepy or unsteady on your feet. Additionally, alcohol can worsen the symptoms of depression or anxiety for which you are being treated.

Grapefruit juice

Unlike some other medicines in their classes, apixaban and sertraline do not have a clinically significant interaction with grapefruit juice. You can consume it as normal.

Foods high in Vitamin K (e.g. leafy greens)

Unlike warfarin, apixaban is not affected by the amount of Vitamin K in your diet. You do not need to limit your intake of spinach, kale, or other leafy greens.

Using other medicines

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.